An unusual malformation of the vermiform appendix simulating endometriosis

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Abstract
A 48 yr old nulliparous woman with a long history of pelvic endometriosis underwent a gynecologic operation and a swollen and indurated appendix was removed because of suspected endometriosis. Pathologic examination revealed no endometriosis, but examination of the distal appendix showed structural disorganization of its entire wall, with lack of proper differentiation of its normal coats and irregular overgrowth of fibroadipose, fibromuscular and neural elements. Differential diagnoses, including endometriosis, carinoid tumor and neurofibromatosis, are discussed.